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001-es BibID:	BIBFORM108005
035-os BibID:	(cikkazonosító)349 (Scopus)85148850132 (WoS)000938286900001
Első szerző:	Kardos Zsófia
Cím:	Tocilizumab in Combination with Corticosteroids in COVID-19 Pneumonia : a Single-centre Retrospective Controlled Study / Zsófia Kardos, Miklós Szabó, Zsuzsanna Baráth, Ágnes Miksi, Csaba Oláh, Ádám Kozma, József A. Gergely, Eszter Csánky, Zoltán Szekanecz
Dátum:	2023
ISSN:	2227-9059
Megjegyzések:	Abstract: Introduction: Interleukin 6 receptor inhibition by tocilizumab (TCZ) has been effectively used worldwide for the treatment of multisystem inflammatory syndrome (MIS) associated with COVID-19. In this single centre study, we compared the outcome of COVID-19 pneumonia in TCZ treated vs. untreated (control) patients. We wished to compare TCZ administration in the general ward vs. in the intensive care unit (ICU). We also studied the role of a consulting rheumatologist in the management of severe COVID-19 pneumonia. Patients and methods: In our patients, COVID 19 pneumonia was confirmed by SARS-CoV-2 PCR, chest X-ray, and CT. We compared patients selected for TCZ treatment with TCZ-untreated age- and sex-matched controls. All patients received corticosteroids. In the TCZ-treated group, patients received one or two doses of TCZ 8 mg/kg IV in combination with corticosteroids. We recorded age, sex, symptom duration, oxygen saturation (SaO2), partial arterial oxygen pressure (PaO2), total white blood cell (WBC), absolute neutrophil, absolute lymphocyte and platelet counts, CRP, ferritin, IL-6, LDH, procalcitonin (PCT), and D-di mer. The primary outcome parameters were the need for ICU, ventilation, death, and time of hos pitalisation. Results: Altogether, 104 patients, 52 TCZ-treated and 52 TCZ-untreated, were included in this study. At baseline, the TCZ-treated patient group indeed had more pronounced COVID-19- related MIS compared to controls. Consultation with a rheumatologist was performed in 60% vs. 40% of cases. Nineteen patients (37%) received one, while 33 (63%) received two TCZ doses. TCZ was administered to 28 patients (54%) in the general ward and to 24 (46%) in the ICU. TCZ treatment was found to be safe in our COVID-19 pneumonia patients. TCZ treatment favourably influenced MIS biomarkers, and was associated with better clinical outcomes compared to controls. Patients receiving TCZ treatment in combination with corticosteroids already in the general ward exerted much better outcomes than those treated in the ICU. Consultation with a rheumatologist also im proved outcome. Conclusions: We successfully used TCZ in combination with corticosteroids in Hungarian COVID-19 pneumonia patients. We pointed out the importance of early treatment al ready in the general ward, and the involvement of a rheumatologist in making treatment decisions.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk COVID-19 IL-6 receptor tocilizumab pneumonia efficacy
Megjelenés:	Biomedicines. - 11 : 2 (2023), p. 1-15. -
További szerzők:	Szabó Miklós (1980-) (tüdőgyógyász) Baráth Zsuzsa Miksi Ágnes Oláh Csaba (1972-) (idegsebész) Kozma Ádám Gergely József A. Csánky Eszter (1959-) (tüdőgyógyász, klinikai immunológus, allergológus) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
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